Saturday, February 27, 2021

The Good Fight

When we last left off, I was supposed to have a calm, mature conversation with my husband about his feelings and fears regarding the embryo transfer.

I’ll spare you the suspense: I fucked it up. Despite talking through the strategy with my therapist beforehand, I came at my husband guns a-blazing. Instead of listening to him, I spewed all my anger at him. I spat dark predictions of what would happen to our marriage if we canceled the transfer. I swore. I made him cry. (Though to be fair, he’s a crier. It doesn’t take much.) I didn't comfort him. I didn’t want to force his hand, but when I thought about calling California IVF to cancel the transfer, hot tears pulsed in my eyes.

After expressing his fears (“I’m staring down 50. I don’t want to be ‘old dad.’”), he tried to smooth things over. He hugged me, said he loved me, and reminded me that we were a team. He tried to be cute and asked our daughter if she would be kind to a little sister.

This did not assuage me. Strangely, it made me angrier. I wanted him to want another baby, and it was so obvious he didn’t. The desire was just not there for him. That’s not to say he wouldn’t love another little girl once she’s here – in fact, he said exactly that. But was that enough?

We weren't getting anywhere (surprise, surprise) and it was getting late so I said we should just stop for now. I needed a moment to process. Questions I asked myself: Am I being unreasonable? Do I secretly want to abandon this dream, too, but I'm making him do the dirty work? Is this an “opportunity” for me to be the bigger person and stop pushing in order to keep the peace? Do I have it in me to do that? Or is that just another form of ego? How do I let this dream go and not expect him to "make it up to me"? Could he ever do that? Why am I wrestling so hard with this? How do I "solve" it without blowing everything up?

I tried to meditate and pray my way to clarity, but I couldn't feel God in this situation at all. I felt abandoned and stuck. I Googled “How to discern God’s will with having children” and came across one helpful blog post by a mother of eight(!). She wrote about how people do not choose how many children they have. God does. Even if you try to take control from Him (i.e. use birth control or the rhythm method or have a vasectomy), He finds a way around it if you are really meant to have a child.

This advice resonated with me. We were not deciding whether or not to have a child. We could try our best by going forward with the transfer, but God would determine whether or not it was successful. We could also opt out, and who knows? Maybe we would get pregnant spontaneously. (Is there an infertile couple out there who doesn’t indulge this fantasy? I doubt it.) Or maybe we were not meant to have more children and no matter what we did or didn’t do, there would be no more children.

In that sense, there was really no “right” or “wrong” way to go about this. No matter which path we took, God would decide whether or not another baby would come to us. Reframing the issue this way lightened the load.

In quiet moments, I kept coming back to wanting to try, at least once, because I didn’t want to regret not trying five or ten years down the road, when it would definitely be too late.

After a cooling-off period, I asked my husband if there was room for compromise. Could we agree to try once and then give up if it doesn't work? He seemed amenable to that. But that would put a lot of pressure on the impending transfer. What if it failed and I wanted to try again? Could I just leave those two unused tries on the table? The gambler in me had her doubts.

I huffed and puffed and stewed and silent treatment-ed my husband for a couple of days. Then, I don’t know what changed exactly, other than I became convinced that the transfer was happening and my husband didn’t resist. There wasn’t one conversation where we “decided” to move forward; it was more of a silent acknowledgment that the decision had already been made, maybe months ago, and we were finally just submitting to the decision.

Two days before my departure date, my treatment coordinator called my husband to get his consent for the transfer. “You have it,” is all he said. It wasn’t as effusive or excited as I would have liked, but it was enough.

So that was that. I was going. Now I just needed to get to Sacramento

Wednesday, February 17, 2021

Indecision City, Population: Two

Embryo transfer date confirmed, backup profile selected, and medication protocol underway, I should have felt settled and satisfied. I felt neither.

A lot had changed since December when we were last approaching an embryo transfer. Our daughter was now mobile and her personality was asserting itself. She was insatiably curious, increasingly stubborn, and needed constant supervision. I’m not complaining (I am nothing if not curious and stubborn myself), but somehow, I’d forgotten that taking care of little babies was actually a breeze compared to burgeoning toddlers.

Our daughter was now sleeping through the night again, but I found myself awake at 1 a.m., staring at the ceiling, wondering if we were being reckless in pursuing the dream of another child.

When my husband and I discussed it, we went 'round and 'round the same concerns about having a sibling for our daughter: Do we have enough money? Can we handle more stress? How will another baby affect our marriage? Will we need to hire help? Can we afford that?

When my husband rattled off all these concerns, any rational person would agree that having another baby was crazy. Ah, but when it comes to babies, I am not a rational person. When I saw siblings out in the world playing together, or I witnessed a sweet moment between my teens, I’d think, “Of course the baby should have a sibling.”

And yet, we'd finally scraped together some balance in our days. In addition to working and parenting, I had time to exercise and meditate and pray every day. I had my body back – no, even better: I was 15 pounds thinner than I was pre-pregnancy. Life was pretty good. Why mess with it?

But then I thought about how every milestone our daughter hit – standing up and clapping are her latest adorable achievements – were the last of these kinds of milestones I would see if there would be no more babies, and that made me sad.

When I rattled off the pros and cons of having another baby in my head, it was clear there was only one pro: that the baby would have a sibling. On the flip side, there were so many cons: health risks, financial strain, marital stress, energy depletion. But I couldn’t bring myself to cancel the transfer – and my husband seemed stuck in a state of resigned inaction.

“I wish there was a professional decision-maker we could go to,” I told my husband after we rent ‘round and ‘round again discussing all this. “We’d give them all the information we have and then they’d decide for us.”

“You want a stranger to make this decision?” he said.

“At least that way, if it was the wrong decision, we could blame the misstep on them.”

My husband thought this idea was ridiculous.

“Well, I would throw ridiculous amounts of money at someone to make decisions for me right now,” I replied.

I mentally toyed with the idea of abandoning the dream of another child and just focusing on our daughter. On easy days, I would dote on our daughter and feel my heart swell with how much I loved her. I would think, “She’s enough – more than enough. Why do I need anyone else?” And on hard days, I would think, “I don’t have the desire or the energy to do all this again from day one.”

One early morning, my husband made this announcement: “I don’t think I can be a good parent to any more children.”

I’ll admit: I’d had similar thoughts. I knew another baby would not get as much affection and attention that our daughter does. There just aren’t enough arms and energy. I also didn’t want my children to grow up in a household with unhappily married parents – though I suppose we were at risk of being unhappy regardless of how many children we had.

But my fears hadn’t outweighed my hope. Not yet. Especially not after my lining check ultrasound, which revealed an incredible 17mm of cushion in my baby house! (For reference, 8mm is the minimal endometrial lining thickness required for a transfer.) Mine was so impressive, the sonographer said, “You go, girl!” 

My husband was not wowed by my super-womb. He was a dark, toxic cloud that loomed over what should have been a time of delightful anticipation. This was why I hadn’t wanted to cancel the transfer in December – I knew that given too much time to contemplate, one or both of us might change our minds.

“Are you saying you want to cancel the transfer?” I asked my husband after he dropped the aforementioned truth bomb.

My husband started to cry, which confused me because I thought canceling would make him happy, right? Didn’t he want to be relieved of the pressure?

“Do you think it’s easy for me to tell you this?” he asked.

It seemed easy enough. He said it, didn’t he? Or did he? What was he saying?

“If you’ve decided we can’t go forward, then you call West Coast IVF and cancel,” I said. “You explain to them that you’ve had a change of heart – if that’s what this even is. I’m not going to be the bad guy.”

Of course, my husband didn’t want to do that. Or maybe he wanted to, but he was afraid of my reaction. So our discussion fizzled out, only to be reignited every few days when something would set us off.

Would canceling the transfer be a relief? Or would it welcome in a new wave of grief? It was easy to pretend I would be calm and regret-free post-cancellation when I still had the transfer scheduled. It’s like fantasizing about breaking up with someone you’re still sleeping with at night and drinking coffee across from every morning. You don’t know how devastating it will be until you actually end it and have to confront the gaping chasm of emptiness where their presence once was.

Also: this wasn’t just a decision about a transfer, or even about a baby – it was about the end of an era. What would it feel like to close the door on my fertility, forever? I wouldn’t know until I got there.

I took to Google, seeking answers. I researched outcomes of only children (because, while I have two teens, the age gap between them and our daughter is 16 and 17 ½ years; our daughter would basically be growing up as an only child). All the studies said that only children fared just fine; they are no more likely to experience loneliness or depression than people with siblings (though they are more likely to be obese, interestingly). Only children are, however, more likely to be successful as adults.

So, there was that – the rational, scientific take on whether or not to have another child. But what about the emotional value of siblings? On this, the internet seemed divided. There are many only children who say they desperately wanted a sibling growing up and/or wish they had one now, as adults, to lean on. There are also many people with siblings who point out that growing up together doesn’t guarantee any kind of bond. Sometimes siblings are close, but they aren’t always. I could certainly think of examples of both scenarios in my family and social circles.

As for the infertility community, I didn’t even bother asking their opinion. Women who have experienced infertility are all incredibly supportive when someone is undergoing treatment, but don’t you dare drop even a hint of ambivalence on their social media spaces. It’s as if the first rule of Infertility Club is: Never, ever give up! No. Matter. What.

“Are you still hellbent on doing this thing on Friday?” my husband asked me one morning.

“It’s on Monday, not Friday,” I replied, frustrated that he couldn’t even remember the timeline of when I was supposed to fly across the country to get pregnant. “And I’m withholding any decision-making until I speak with my therapist.”

I think my husband thought my therapist would talk me out of the transfer. I hoped for the opposite – that she would encourage me onward. Of course, what I got was typical therapist spiel: objectivity and non-answers. Don’t get me wrong; it felt cathartic to talk it all out with Shania. But her conclusion was: “It’s not the decision itself that matters; it’s how you two come to a decision together.”

It reminded me of a column in The Atlantic by therapist Lori Gottlieb (whose perspective I usually love) in which a woman was considering divorce because her husband refused to give her another child. Gottlieb essentially told the woman to coddle her husband’s feelings and accept that she might have to smother her baby dream so that her husband could take more naps. (This is my ruthless interpretation, which is naturally biased given that I’m going through a similar situation; others will probably read it differently.)

I told Shania that my husband and I have talked this thing to death and we just keep having the same conversation. I already know his fears about moving forward (money, stress, relationship quality) and his fears about not moving forward (my anger and resentment). I know why he sticks his head in the sand (he’s afraid of my reactions; as he probably should be). What new information could possibly come from another conversation?

Shania gave me a set of questions to ask my husband and encouraged me to be non-threatening when listening to the answers. She told me to be present in the process and to avoid charging ahead to the outcome. 

But instead of feeling curious and compassionate about what my husband was going through, I was infuriated. Why did it seem like he got to make this decision, not me? How could we make a decision together if we couldn't agree on how to proceed? And when it comes to having a baby with IVF, there really is no such thing as compromise. You either do it or you don’t.

During our session, Shania acknowledged how frustrating it was that I’d spent the last six months filling out paperwork, fighting with West Coast IVF, undergoing procedures, and taking medications, only to have to contemplate canceling the transfer this late in the game. If we were going to shut down the baby factory, what the fuck had I spent the last half-year doing? Was it all for nothing?

“It’s like training for a marathon and not getting to run it,” she said.

Yes…but no. It’s like training for a marathon and being told you will never run again, even though you’re raring to go and your body is perfectly capable.

So here we are, on the cusp of one of the most important decisions of our marriage – if not our lives – and I’m instructed to just sit back and listen (’cause that will go well) while my half-packed suitcase awaits next to the bed...

Sunday, February 7, 2021

Hurry Up And Wait (And Deliberate)

After a hellish month due to my baby’s breathing issues, I finally received a new embryo transfer date, for late February. Though the health drama had been giving me second thoughts about moving forward, once I saw the treatment calendar, I was all in again.

I giddily booked my travel arrangements and scheduled my ultrasounds. I refilled my prescriptions. I calculated the due date and corresponding astrological sign of the potential baby-to-be. I brainstormed new names. I attached to the idea of her. I let myself feel hopeful again. 

Then I received another email from my treatment coordinator. She’d forgotten that I wasn’t on birth control. (Of course I wasn’t…because she told me to stop all medications in December!) The embryo transfer date was null and void. I would have to wait for my next period and reschedule. Again.

I lost it. I went full Karen on the clinic manager. (Again.) I threatened to pull out of the contract, demand my refund, and pursue treatment elsewhere. Of course, I didn’t want to do that, because it wouldn’t get me pregnant any faster.

A nurse called to talk me off the ledge.

“There’s still a chance you could keep the transfer date,” she said. “When was your last period?”

“December 26,” I told her. And that one, as far as I could tell, only happened because I stopped all the fertility meds when my previous transfer was canceled.

“Are your periods regular?”

“They haven’t been,” I said. I explained about my missing period in the fall and the Provera I had to take to get it back. There had been nothing “regular” about my cycles since…oh…2019, before I got on the infertility treatment roller coaster.

“We need to figure out if you’re growing follicles,” she said. “Because if you are, your body might be releasing hormones that could interfere with the medication protocol.”

I didn’t know the details of my follicular count, but I knew that in the past, it had been puny. The nurse reviewed my last baseline ultrasound and my SIS and confirmed there wasn’t much happening in the follicle department – but was that because I had been on birth control? Or because I was old?

“One advantage of being a seasoned woman,” she said (and, yes, that was the term she used), “is that we don’t grow many follicles. So I think we should do an ultrasound, see what’s going on in there, and if it’s not much, then we could potentially go straight to Lupron and stay on track for late February. What do you want to do?”

It was a risk, diverging from the tried-and-true protocol that had worked when I got pregnant with a donor embryo the first time, but at this point, I was feeling desperate. I had re-entered West Coast IVF’s program back in August and I still hadn’t had a transfer. I didn’t want to wait anymore. I wasn’t sure I could.

“Let’s try,” I said.

And so, the following Monday, I trekked to Dr. Baby-Maker’s clinic, where I once again submitted myself to another baseline ultrasound. As the sonographer readied the machine, she asked about my infertility journey so far. I told her all about the tooth ordeal and the canceled transfer in December. The tone of her voice indicated she truly felt sorry for me. Pity was nice, I guess, but what I needed more were answers.

The sonographer quickly found three small follicles (nothing to write home about) on the left ovary. As for the right? It was playing hide-and-seek. The sonographer maneuvered the wand in a thousand uncomfortable positions and she simply could not find it.

“I think it’s right behind this bowel activity,” she said, indicating what looked like a pulsing tube on the screen. Basically, I think she was saying that I was full of shit. (‘Cause that’s not mortifying.)

She dug around a little while longer, then (I think) gave up, grabbed a screenshot of something oval-esque, and called it an ovary for the report’s sake.

“I’ll send this off to California right away,” she said. “Hopefully you can get going already.”

I had my doubts, but later that day, I received confirmation from the doctor that I could start Lupron and keep the February transfer date. Hooray!

My treatment coordinator soon called to make sure my concerns had been addressed. Since she asked, I told her that there was one other unresolved issue: I felt uncomfortable with our backup embryo option, the one that included an egg donor who had a relative with schizophrenia and an unclear family history of mental retardation. I wanted to see more profiles – specifically those with proven fertility.

To make things easier, I told her I was open to any race. It was something I’d been thinking a lot about over the past several weeks. White couples adopted BIPOC children all the time; why would this be any different? It would be challenging, of course, and my husband and I would have to educate ourselves and immerse our child in her culture, but we were willing and eager to do so if it meant a healthier baby.

Within hours, I had a new backup profile in my inbox.

This profile had already been successful for another West Coast IVF patient. Unfortunately, that was about all that it had going for it. The egg donor’s family has a history of obesity. The sperm donor’s family had a history of high blood pressure, stroke, pneumonia, melanoma and breast cancer.

I didn’t hesitate to turn that one down. There had to be better options. And since I’d complained, the clinic seemed more willing to offer them to me.

The next backup profile arrived – and I fell in love with it.

The egg donor was athletic, articulate, and creative. Her favorite movie: The Princess Bride. Favorite book: The Great Gatsby. Favorite season: spring. And her health history was impeccable. The sperm donor was fit, entrepreneurial, and clearly had a sense of humor (“Love dogs, think fish are hilarious, cats are demon creatures”). His personality absolutely burst off the page. His family health history wasn’t flawless, but there weren’t any concerning patterns.

I looked up the sperm donor’s ID on the Facebook group for the sperm bank. Picture after picture of babies made from his genetic material came up. The sperm donor’s genes were clearly the dominant ones in all of his offspring – but his genes and my family's looked nothing alike. The kids were adorable, but it would be obvious to everyone that this baby wasn't “ours.”

I was concerned about how this baby would handle questions about her origins. I thought of a line from the children’s book we have about donor conception that goes, “To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in.” I imagined our future child stuck having many interactions like this:

Random Person: Are you adopted?

Future Child: No, I’m donor-conceived.

Random Person: What’s that?

Future Child: To make a baby, you need a seed from a man, an egg from a woman, and a nice warm tummy to grow the baby in…

It seemed unfair to subject a child to incessant questioning, not to mention racism. And yet, I could feel the good vibes from this profile. It also had one current pregnancy, a better track record than our chosen profile, which had a negative pregnancy test and a chemical pregnancy to its name.

I had to ask myself: Did I want the fantasy of a baby (who might look like my husband and me) or did I want a flesh-and-blood baby (who would definitely not look like either of us)? I could clearly imagine myself with the baby from our chosen profile; I wasn’t sure I could see myself with the new one. (Though I know I would love any baby put into my arms.) 

The clock was ticking. My coordinator needed a yes or a no. And she needed to know which profile was primary. If I chose the new one to be my primary, I would have to give the old one up (because the new one had multiple female embryos available, so I wouldn’t need a backup). 

My husband was firmly on the side of the new profile, his reasoning being: if we’re going to do this, we want it to work. My younger teen agreed. My older teen and I were waffling. We didn’t want to let go of the old profile. But what if the transfer with the old profile failed? I’d be kicking myself for months over wasting all this time and money. 

I wished for the impossible (of course I did): that we could transfer one of each and let fate decide, but I was pretty sure the clinic wouldn't allow that, and I didn't want to risk twins. (Imagine explaining twins genetically unrelated to us and one another!)

Ultimately, I let myself be persuaded by reason. The new profile had the best chance of success, so that was the one I was going to choose.

But on the morning I was supposed to send back the confirmation form, my printer refused to print. I tried once, twice, three times. There was still ink in the cartridge, but the text wasn’t printing clearly. I signed up for a free trial of Adobe and tried to e-sign it, but the document wouldn’t let me edit a section of the document where I needed to print my name. “Is this a sign?” I asked aloud to no one in particular.

If it was a sign, I ignored it. I ordered a new ink cartridge, got it installed, printed off the confirmation page, and signed it along with my husband before the day was done.

“We’re sure about this, right?” I asked him.

“I’m done discussing this,” he said. (All this deliberation had begun to sour him on the whole endeavor. Topic for a future post...)

I emailed the signed confirmation form to my coordinator. So that was that; we were letting go of the old profile and would be transferring a female embryo from the new profile in late February.

Only a few minutes after sending the confirmation, my treatment coordinator responded, confused. Did we want the new profile as the primary? Or as the backup?

I stared at the message for a long time, unsure how to respond. It felt like all day, the signs were saying, “Don’t let go of the profile you love.” Now she was giving me another chance to change my mind. Should I take it?

I typed up my email response, with two lines: “Primary” and “Backup.” I copied and pasted the profile numbers – the old one for primary, the new one for backup. Then I swapped them. But I couldn’t press “send.”

I tried to imagine how I would feel months from now, pregnant or not, if I let the old profile go. Even worse: what if someone else got pregnant with that embryo? What if I saw a picture of that baby in the West Coast IVF Facebook group? Would I feel like she should have been “mine,” just like I did with my baby’s only full genetic sibling who was growing up halfway across the country? (I would give anything to have had another embryo from her profile available. Then there would have been zero deliberation; only celebration.)

Something in me again said, “Try.” I had to give the embryo I wanted most a chance. If the transfer was unsuccessful, the new profile would still have an embryo ready and waiting. (Though the age gap between my baby and her little-sister-to-be would be close to two years at that point.)

I told my coordinator to keep the old profile as the primary and the new profile as a backup. And then I told myself to stop deliberating. (‘Cause that works.)

This process revealed traits in me I didn’t recognize – and didn’t like. I used to be so decisive and now I seemed so wishy-washy. Also: why, after I pushed and pushed to get what I wanted (in this case, a backup profile worthy of being a primary profile), did I reject it once I got it?

And, most pressing: now that preparation for the next transfer was underway, why did I suddenly feel so ambivalent about moving forward at all, with any profile?